No matter which health outcome is examined, there exists a quite strong association with education. Moreover, within virtually all chronic diseases of mature adult populations, there remains a very powerful health gradient with years of schooling. In this proposed research, we will extend our earlier National Institute of Aging funded research by investigating the ability of individuals across different education levels to comply with and maintain complex health regimens that are often prescribed to deal effectively with severe health problems. Using both observational and cohort studies, we will isolate the major factors associated with better medical self-management behavior among those with chronic diseases. Particular emphasis will be placed on the role that education plays in promoting better adherence and in isolating those factors that might help explain why and when education affects adherence. We will also access the importance of patient self-management and adherence to medical regimens in promoting better health outcomes across several salient illnesses, most of which are more prevalent in a older population. These illnesses will include hypertension, high cholesterol, heart disease, diabetes, asthma, and arthritis. The requirements for self-management may vary considerably across different types of illnesses, as may the consequences of non-adherence on subsequent health outcomes. Finally, we will evaluate the relative importance of patient self-management and adherence as a factor accounting for the significant education health gradient across these chronic illnesses.